Methamphetamine: the booming drug that worries Europe

There was a time when methamphetamine, an addictive stimulant with high potential for damaging health, was legal and used for everything.

In Germany, under the trade name of Pervitin, it was used by secretaries to type faster, by new mothers to combat postpartum depression, by truckers to be more alert on the road, and even by the Nazi army to take over France in the well-known

. the blitzkrieg

In the thirties of the 20th century, methamphetamine was in Germany "a kind of anti-drug called to replace all toxic substances", explains the writer Norman Ohler, in his work

.

"A kind of panacea," he says, which was good for a tear and a tear.

"It didn't matter: no matter what hurt, the Germans always reached for the little blue, white and red tube of Pervitin," says Ohler.

With it—or thanks to it—the Nazis even came close to winning World War II.

Today, methamphetamine is considered one of the most dangerous and destructive drugs, only behind heroin and crack: it is a very powerful synthetic stimulant that can generate high levels of dependency and serious cardiac and psychotic conditions.

Pervitin no longer exists, but in practice, this substance continues to circulate on the street, in the form of powder, pills or small crystals that are usually inhaled, smoked or injected.

In fact, this same drug that harangued Hitler's troops throughout Europe almost a century ago, has now raised the concern of the health authorities of the old continent.

A report from the European Monitoring Center for Drugs and Drug Addiction (EMCDDA) warned last year that "the user market in Europe is relatively small,

More information

Wastewater reveals what drugs the city consumes: cocaine in southern Europe and methamphetamine in the east

All radars point in that direction.

Towards "the growing threat posed by this drug in the region, as availability increases and consumption spreads to new areas," warned the EMCDDA.

Andrew Cunningham, EMCDDA's head of Markets and Crime, insists by email to EL PAÍS that methamphetamine "is the most widely consumed synthetic stimulant drug in the world", and although "Europe is still a relatively small market compared to Asia, North America and Australia, there are concerns that it may be growing here."

Historically, its use has been concentrated in the Czech Republic and Slovakia, but there are "signs of increasing use in some countries," says Cunningham.

A study in wastewater from European cities published this Wednesday reported an increase in the presence of methamphetamine beyond its traditional strongholds: it is also present in Belgium, eastern Germany, Spain, Cyprus and Turkey and several countries in northern Europe.

“Of the 60 cities with data for 2021 and 2022, almost two-thirds (39) reported an increase in waste,” the report notes.

Data from supervised drug consumption rooms in Barcelona and Oslo, for example, have reported an increase in methamphetamine use.

"In Athens, there have also been reports of a growing problem of sisa (crystal methamphetamine) use," adds the EMCDDA expert.

There has also been an increase in reported crimes for possession or use of this substance between 2015 and 2020.

Another of the radars, the initiation of addiction treatment, reflects that, although requests for help for methamphetamine addiction remain low compared to other substances, there has been "a gradual increase" since 2015 in most countries with available data, says the expert.

That year, with data from 14 countries, 637 people started treatment for this substance;

in 2020, it was 25% more: 797 individuals.

Methamphetamine is considered one of the most dangerous and destructive drugs, behind only heroin and crack.

In an EMCDDA webinar held a few weeks ago, a couple of researchers from Barcelona x-rayed the situation detected in the city: although consumption is still in the minority when compared to other drugs, methamphetamine continues an upward trend.

“It has been detected mainly in Madrid and Barcelona.

This does not mean that there is no methamphetamine in other cities, but Barcelona, ​​for example, has implemented wastewater analysis since 2011 and that allows it to monitor [substances]: from 2017 and 2018, we are detecting a slight increase in methamphetamine , which is located in very specific populations”, explains Ester Aranda, a participant in this conference and attached to the Directorate of the Drugs and Health Area of ​​the Well-being and Development Association (ABD).

The more—and better—you search, the more you find.

The ASPB has all of its alert systems active to detect any movement and has already noted a slight increase: in 2016, 31 people began drug addiction treatment in the city for methamphetamine;

in 2021, there were 133. Among the harm reduction services, the ASPB has had a program for the use of pipes for inhaled consumption in Baluard since 2019, which is how most reported users in Barcelona take methamphetamine.

In 2021, the ASPB registered some 3,000 accesses to supervised consumption rooms - the same person can enter several times - for methamphetamine.

This means 6% of the total entries.

In 2022, it was 6.6%: 3,900 accesses to consume this substance.

"If we look at all the people who come to consume, methamphetamine is a very small proportion, but our obligation is to always act on a preventive level," defends Montse Bartroli, head of Attention to Drug Addictions at the ASPB.

You have to prepare.

Above all, seeing the precedents in other countries, where the statistics of methamphetamine overdose deaths draw a wall, the ascending line of the exponential increase that worries public health experts.

In the United States, immersed in a deep opioid overdose crisis, a study on deaths linked to methamphetamine between 1999 and 2021 reports "unprecedented increases" in deaths: in two decades, there were around 135,000 deaths, and about 43 % of these deaths also involved heroin or fentanyl.

devastating drug

Despite the fame acquired for his role in the

series , where chemistry professor Walter White cooked kilos and kilos of this drug in an old traveling trailer, methamphetamine is devastating.

For physical and mental health.

“It is a very powerful stimulant.

It easily passes the blood-brain barrier [which protects the brain] and has a dopamine-releasing effect.

It causes acceleration, energy, euphoria... But there is a risk of psychotic breaks and, unlike other substances, these can be prolonged over time.

Some end up being diagnosed with schizophrenia due to the persistence of symptoms”, explains Rosa Sauras, a psychiatrist at the Dual Pathology Unit of the Hospital del Mar in Barcelona.

They call it, colloquially,

or

or

,

or

, if it comes in the form of crystals.

According to the monograph of the National Plan on Drugs, this substance causes, in the short term, loss of appetite, increased heart and respiratory rates, and psychiatric effects, such as paranoia, anxiety, insomnia, panic attacks, and aggressive behavior.

In the long term, in addition to addiction, psychiatric symptoms are accentuated, such as visual and auditory hallucinations or delusions, which can be maintained for a long time or reappear in times of stress.

At the Hospital del Mar, they have been seeing an increase in admissions to the emergency room for several years due to overdose, heart or psychiatric problems associated with the use of methamphetamine.

“In psychiatry we provide care in three devices.

At the drug addiction care center we see a slow increase and it is difficult for them to ask for help.

Through the consultation service, we see patients admitted to other parts of the hospital, for example, in cardiology for cardiomyopathies, and who notify us because there is a consumption disorder.

In the dual pathology unit, we have those who are admitted from the psychiatric emergency room due to hallucinations or psychotic episodes and there are symptoms that do not resolve ”, warns Sauras.

In this unit, they've gone from seeing a couple of meth-associated patients a year to seeing two every month.

We have those who are admitted from psychiatric emergencies due to hallucinations or psychotic outbreaks and there are pictures that are not resolved ”

Rosa Sauras, psychiatrist at Hospital del Mar

There is no defined consumer profile.

It is heterogeneous and has varied over the years, Sauras points out: "When cases began to arrive, in 2016, we saw it in people from the Filipino community, who smoked, associated with work use, to endure more work."

Now there are also traditional users of other substances that they combine with methamphetamine and, on the other hand, chemsex users, a phenomenon almost exclusive to the group of men who have sex with other men and which is characterized by the intentional use of drugs to have sexual intercourse for a long period of time.

It may be associated with leisure contexts or highly vulnerable environments, such as people who live on the street.

Researchers from the Hospital Clínic de Barcelona analyzed in a study the effects of methamphetamine on the mental health of chemsex users: among fifty patients, 80% went to the addiction unit for consumption of this drug and the majority consumed it smoked;

more than a third of the participants had psychotic symptoms.

“Barcelona is one of the cities with the greatest impact on chemsex and methamphetamine is one of the most widely used drugs.

Its use has spread through chemsex”, contextualizes Lorena de la Mora, signatory of the study.

Now, she adds, "the consequences of prolonged use of methamphetamine [in chemsex contexts] are being seen, such as psychotic disorders and psychological deficits and neurotoxicity that this substance can cause," she warns.

attack the offer

The therapeutic approach is complex.

To begin with, because "there is no specific drug treatment," admits Sauras.

And it is not easy for them to adhere to the therapy: “The person arrives at the hospital when he is in full decompensation and the link with the treatment center is very difficult.

In the Filipino community, for example, consumption is highly stigmatized, there are language barriers and ignorance of the health system does not help either”, exemplifies the psychiatrist from Hospital del Mar.

Adherence to the care resource is key, Bartroli points out, and it is important to "work on the professional link": "From the field of harm reduction, we do prevention: we prevent consumption from being compulsive, unsafe and we try to work with the person so that, when you are prepared, you can move into a treatment process.

Aranda assures that the work infrastructure in Barcelona to address the increase in cases "is prepared" and, he admits, this gives him "tranquility".

The other area to stop this phenomenon on the rise is to “attack the supply”, Bartroli resolves.

And precisely in this field, Cunningham admits that there are worrying signs.

"Europe is a destination and transit area for methamphetamine produced in other production centers, such as Iran, Nigeria and, more recently, Mexico," he explains.

Industrial-scale production of this drug in Europe has grown and become more sophisticated and the development of methamphetamine production capacity in Afghanistan, Europe's main source of heroin supply, also poses "a potential threat" to the EU, it warns. the expert.

If it continues to rise, methamphetamine could become a huge snowball of problems, with very serious health consequences, "the possibility of an increase in serious violence, the expansion of organized crime, corruption and money laundering" , lists Cunningham.

Although there are no data on how this phenomenon will evolve, the expert is not very optimistic: "There are reasons to believe that the use may spread to a greater number of people and to a diverse group of users, with serious consequences for the health and safety of the Europeans".

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